The alcohol screening day in Catalonia: beyond the identification of alcohol- related problems
INEBRIA-LATINA
Joan Colom, Jorge Palacio-Vieira, Lidia Segura Garcia, Estela Diaz, Rosa Freixedas, Nuria Bastida, Antoni Gual
Thursday, 27th September Introduction
•Drink-less project dissemination started in 2002 resulting in increased early identification of alcohol-related problems in Catalonia.
•Risky drinkers at Primary Care (PC) remain under-detected [Segura L, 2006]. • Screening tools not adequate • Only low risky drinkers screened
•Raising awareness among professionals and general population is, together with training and support, an essential part of the activities carried out in the framework of the Drink-Less project (Beveu Menys) in Catalonia. Objective
•Raising awareness campaign inspired by the National Alcohol Screening Day of United States [Greenfield SF, 1999]
Aimed at: -Encouraging the use of standardized instruments -Improving early detection of risky drinkers at PC -Raising awareness among the general population regarding alcohol problems.
Methods
•All referents of alcohol in Catalonia were invited to participate voluntarily (562 professionals of 365 centres of Primary Care ).
• 2 consecutive years (2010 & 2011) around the 15th of November (“el día sin alcohol”).
•Identification (AUDIT-C paper or electronic) + leaflet
•Risk of alcohol consumption (cut-points) Men: Risk>=5 Women: Risk>=4 Characteristics of participating centres
Rural Urban Unknown Rural Urban Unknown 0 0 7.9 8
57.9 58.6 54.3 54.3
42.1 41.4 37.8 37.7
2010 2011 2010 2011
Participating centres Non-participating centres The distribution of participating centers (rural/urban) was not different of the distribution of non-participating centres. Total of patients screened by age group and sex
2010 2011 Age group Women (%) Men (%) Women (%) Men (%) 15 – 44 years 258 (35.8) 195 (30,4) 339 (33.2) 222 (24.3) 45 – 64 years 255 (35.4) 205 (31,9) 332 (32.5) 318 (34.9) 65 + years 297 (28.7) 242 (37,7) 351 (34.3) 372 (40.1) 810 (55.7) 642 (44.3) 1022 (52.8) 912 (47.2) Total 1452 (100) 1934 (100)
The number of patients screened increase year by year, the number of women is higher and there is a similar distribution among age groups. Patients screened by age group versus average month visits
100.00
90.00 26.72 80.00 37.12 37.38
70.00
60.00 31.15 65 + years 50.00 31.68 33.61 45 – 64 years 40.00 15 – 44 years
30.00
20.00 42.13 31.20 29.01 10.00
0.00 2010 2011 Average month
Compared with the distribution of age-groups of the average visits by month, there has been a higher proportion of patients aged 65+ screened. Alcohol consumption risk (AUDIT-C)
30 30 26.9 25.1 25.8 25 25 21.6 22 19.8 19.3 18.9 20 17.9 20 18.2 18.1 14.9 15 15
10 10
5 5
0 0 18 -34 y 35 - 59 y 60 + 18 -34 y 35 - 59 y 60 +
Women Men Women Men
2010 2011 Similar prevalences year by year but always higher proportion of risky drinkers among males 35-59. Alcohol consumption risk (AUDIT-C)
25
22.5 21.8 22
20 20 18.85 19.1
15
2010 2011 10
5
0 18 -34 y 35 - 59 y 60 + Identification with standardized tools versus current medical record tools
120.0
100.0 97.5
79.8 80.0
60.0
40.0
20.2 20.0
2.5 0.0 Risk Low risc
Total 2010-2011 Refere ICS 8 times higher with standardized tools Conclusions
Besides low participation, the alcohol screening day in Catalonia showed the feasibility of using standardized instruments in PHC.
The prevalence of risky drinkers with AUDIT is 8 times higher than the prevalence identified in the medical record.
The screening day in Catalonia increases the public and professionals' awareness on alcohol problems and facilitates its early identification.
Participation increases year by year and we would like to extend it to all PHC centres in Catalonia.
Including the AUDIT tool as a standard EI tool in the medical record of Catalonia is a future challenge.
Acknowledgements
ABS Sils-Vidreres-Maçanet-Riudarenes ABS Salt ABS Badalona 2, Centre ABS Barcelona 10-D, Besòs ABS Sant Feliu de Llobregat 1, El Pla ABS Sant Feliu de Guíxols ABS Badalona 4, El Gorg ABS Molins de Rei ABS La Jonquera ABS Girona 3, Montilivi-Vila-roja ABS Roses ABS Reus 1, Sant Pere ABS Manlleu ABS Girona 4, Taialà (Joan Vilaplana) ABS Arbúcies-St. Hilari ABS Lleida Rural Sud ABS Terrassa B, Terrassa Est ABS Barcelona 10-G, El Clot ABS El Prat de Llobregat 2, 17 de setembre ABS Tarragona 4 (Complex Llevant) ABS Olot ABS Sabadell 4-B, Can Rull ABS Badalona 1, Martí i Julià ABS Almenar-Alfarràs-Alguaire ABS Terrassa G, Terrassa Sud, Can Jofresa ABS Amposta ABS Manresa 2, Plaça Catalunya ABS Sant Boi de Llobregat 3, Camps Blancs ABS Manresa 3, Les Bases de Manresa ABS Barcelona 9-G, Sant Andreu Est ABS Calaf ABS Sant Vicenç dels Horts 2-El Serral ABS Terrassa A, Sant Llàtzer ABS Vilaseca ABS Salt-2 ABS L’Hospitalet de Llobregat 3, Collblanc ABS Baix Penedès Interior (L’Arboç) ABS Cassà de la Selva ABS Barcelona 10-F, Camp de l’Arpa (CAP Maragall) ABS Cardona